Defend Private Healthcare

[D'rok]

Your doctor is also free to practice medicine without checking first with an insurance company clerk.

Yup. I can't be denied service.

 

[Ivor the Engineer]

In other words, consumers are too stupid to shop for their own medical services in a free market, so we need Big Brother to protect us by removing all our choices, lest we make the wrong ones.

I do not equate stupid with having a lack of information or the knowledge to make informed decisions based on information provided.

Having said that, should physicians be allowed to exploit people of low intelligence or those who cannot make informed choices?

 

[Mark6]

Ok. I understand what you're saying. Here's where I think you aren't making a good argument. You are making an assumption that the only incentive for excellence in the medical profession is the opportunity to bill high. I think you would have to back that up with data. Are medical professionals in universal systems like Canada's really less outstanding? Would you admit the possibility that doctors could have incentives other than money to strive for excellence?

Yes, I admit that doctors have incentives other than money to strive for excellence. However, I think that giving them money incentive as well is a positive thing.

"Are medical professionals in universal systems like Canada's really less outstanding?" Yes, I would have to do research to answer this question. Which is not easy considering that "outstanding" is a somewhat subjective term. But I will try

 

[ponderingturtle]

There you go. If I were that dentist, I would not live in a country with Canada's laws. Why should I settle for being paid less than what patients, free to choose a cheaper dentist, are willing to pay me?

And I am sure you would never want to live in a country that you couldn't use your money to live longer than someone of less means. Provided you were not the person of less means.

 

[ponderingturtle]

In other words, consumers are too stupid to shop for their own medical services in a free market, so we need Big Brother to protect us by removing all our choices, lest we make the wrong ones.

Damn you FDA, for all the things you have outlawed.

 

[Mark6]

And I am sure you would never want to live in a country that you couldn't use your money to live longer than someone of less means. Provided you were not the person of less means.

Life is not fair. Bill Gates, Bill Clinton, and Hugh Hefner can afford medical care I can not. So what? Prices drop. Ten years from now I will be able to afford what they can afford now -- even while some newest procedure will remain out of my reach. I still prefer to live in the country where medicine advances fastest, even if the price of it is newest life-saving procedure are only available to those of great means.

 

[quixotecoyote]

Life is not fair. Bill Gates, Bill Clinton, and Hugh Hefner can afford medical care I can not. So what? Prices drop. Ten years from now I will be able to afford what they can afford now -- even while some newest procedure will remain out of my reach. I still prefer to live in the country where medicine advances fastest, even if the price of it is newest life-saving procedure are only available to those of great means.

Are you sure you have your facts straight?

I have a sneaking suspicion the thought process here went:

"US style healthcare systems lead to the fastest health care advances.

We know this because the fastest health care advances come from US style systems."

 

[Mark6]

I have a sneaking suspicion the thought process here went:

"US style healthcare systems lead to the fastest health care advances.

We know this because the fastest health care advances come from US style systems."

Are you saying that's not the case?

 

[Ivor the Engineer]

Life is not fair. Bill Gates, Bill Clinton, and Hugh Hefner can afford medical care I can not. So what? Prices drop. Ten years from now I will be able to afford what they can afford now -- even while some newest procedure will remain out of my reach. I still prefer to live in the country where medicine advances fastest, even if the price of it is newest life-saving procedure are only available to those of great means.

Got access to a stem-cell trachea transplant in the US?

 

[thesyntaxera]

The more stuff to buy = more costs = longer, healthier lives. Restricting profit slows development, and more people suffer because of that than socialized medicine helps.

Is there any evidence that backs this statement up, or is this just a blanket assumption based largely on a personal bias against national health systems?

The fact is:
http://student.pnhp.org/content/what_about_physician_salaries.php

Salaries are not that different...

Any drop in income a physician might experience under a single-payer system would be mitigated by a drastic reduction in practice costs. For instance, the average malpractice premium for an Ob/Gyn, the medical specialty with the highest malpractice rates, was $195,000 in Florida for 20045. Comparatively, in the most expensive province in Canada for 2008, the malpractice rate for an Ob/Gyn was $33,563.28 annually, or $161,000 less than Florida’s6.

If a person is only practicing medicine because it makes them a lot of money then perhaps they should be doing something different for a living. These debates almost always seem to revolve around the idea of income and who is making more, when it seems the most logical and certainly the most humane position is one that values human life more than money.

The United States is one of the most, if not the most expensive health care systems in the world...
The US Health Care system: Best in the World, or just the most expensive?
http://dll.umaine.edu/ble/U.S. HCweb.pdf

The World Health Organization's ranking of the world's health systems:
http://www.photius.com/rankings/healthranks.html

The US is 37th.

The WHO life expectancy Rating:
http://www.photius.com/rankings/healthy_life_table2.html

The US is 24th.

WHO Health Performance Ranking:
http://www.photius.com/rankings/world_health_performance_ranks.html

The US is 72nd.

WHO Total Health Expenditures as % of GDP, 2002-2005 - Country Rankings:
http://www.photius.com/rankings/total_health_expenditure_as_pecent_of_gdp_2000_to_2005.html

The US is number 2, after the Marshall Islands.


So, the quick summary is that countries with National Health Insurance have better care all around, and have lower spending compared to completely private systems. Also, that wage differences aren't that significant.

 

[Mark6]

Got access to a stem-cell trachea transplant in the US?

It happens to be today's news but does not prove anything. Some spectacular advances are bound to happen outside US. Thesyntaxera's post is much more convincing -- it is true that US life expectancy is 24th in the world despite 2nd largest per capita health care expenditures. However, US health care costs are driven up by absurdly litiginous climate which does not exist in Europe. Without it, US costs would have been much lower.

 

[gtc]

Sounds like we have a failure in communication. This is the situation I am describing:

1. Insurance provider pays X amount for a dental procedure.

2. Most dentists charge X + some small Y. Patient pays Y out of his pocket. Y value may vary.

3. Some dentist only charge X. Patient pays nothing.

4. Nothing prevents a dentist from charging X + very large Y, possibly more than X. Insurance provider will still pay only X. Patient will pay much larger amount. Obviously, he will get business only if he is significantly better than other dentists.

Australia has a mixed public/private medical system. We are covered by the public system and can choose to take out private insurance.

Amongst other things, the public system involves public hospitals and subsidies for visits to GPs and medicines.

The government will pay a certain amount towards the cost of visiting a GP, I am free to choose which GP I visit and how often I visit. Some GPs charge an additional fee on top of the government subsidy, others do not. I am not sure if there is any regulation of fees.

Generally medicines are subsidised by the government with a top up fee set by the pharmacist. Pensioners pay a nominal fee of a few dollars and generic medicines are cheaper than brand names. The top up fee varies from location to location and I don't know if it is regulated.

Private health insurance doesn't cover the costs of visiting a GP or purchasing medicine as far as I am aware.

If I need to visit a hospital I can choose a public hospital, which may involve a waiting list or a private hospital, where the waiting list is hopefully shorter. Our state government was recently accused of refusing to let patients onto the waiting list for public hospitals as a way of curbing waiting lists.

As far as I am aware, public hospitals are generally free with private hospitals charging a top up fee on top of the amount covered by private health insurance. The size of the top up fee, if any, depends on the level of health insurance purchased. I don't know if the government subsidises private hospitals as well as public. I think private insurers have lists of approved private hospitals and specialists etc to ensure that costs are reasonable.

Dentistry is covered by private insurers, I don't know of the extent to which the government subsidises this.

 

[Ivor the Engineer]

It happens to be today's news but does not prove anything. Some spectacular advances are bound to happen outside US. Thesyntaxera's post is much more convincing -- it is true that US life expectancy is 24th in the world despite 2nd largest per capita health care expenditures. However, US health care costs are driven up by absurdly litiginous climate which does not exist in Europe. Without it, US costs would have been much lower.

So are you saying you think physicians need an even larger share of the power in the physician-patient relationship to protect them from being sued?

 

[Mark6]

So are you saying you think physicians need an even larger share of the power in the physician-patient relationship to protect them from being sued?

Well, do you think British doctors are overly protected from being sued?

The difference between US tort system and that of the rest of Western world (including Britain) is that in the rest of Western world, LOSER PAYS. Consequently in Britain people initiate lawsuits only if they have reasonable expectations of winning -- in case of doctor-patient relationship, only if doctor really did something wrong. In US anyone can sue a doctor (or anyone else, for that matter) with absolutely no danger to themselves. A lot of tort lawyers accept cases on "percentage fee" basis -- if plaintiff loses the case he pays nothing, if plaintiff wins, the lawyer gets a percentage. The defendant has to pay lawyer fee even if he wins. Most tort cases never reach the court -- the defendant (doctor, in this case) pays the plaintiff just to get rid of him; it is actually cheaper than winning the case. Whether or not he did anything wrong. Doctors' malpractice insurance premiums reflect the fact that any doctor can be sued at any time. Do you see now why US medical costs are highest in the world?

 

[Ivor the Engineer]

But hang on. You claim to have the best health care system in the world. Why on earth would so many physicians in the US be being sued if they all provide such a good service?

BTW, IIRC most claims in the UK are against hospital trusts rather than individual physicians.

 

[Mark6]

But hang on. You claim to have the best health care system in the world.

I never claimed that. I claimed it is most conducive to innovation.

Why on earth would so many physicians in the US be being sued if they all provide such a good service?

Because too many people are greedy and can get away with it.

 

[Lonewulf]

Well, do you think British doctors are overly protected from being sued?

The difference between US tort system and that of the rest of Western world (including Britain) is that in the rest of Western world, LOSER PAYS. Consequently in Britain people initiate lawsuits only if they have reasonable expectations of winning -- in case of doctor-patient relationship, only if doctor really did something wrong. In US anyone can sue a doctor (or anyone else, for that matter) with absolutely no danger to themselves. A lot of tort lawyers accept cases on "percentage fee" basis -- if plaintiff loses the case he pays nothing, if plaintiff wins, the lawyer gets a percentage. The defendant has to pay lawyer fee even if he wins. Most tort cases never reach the court -- the defendant (doctor, in this case) pays the plaintiff just to get rid of him; it is actually cheaper than winning the case. Whether or not he did anything wrong. Doctors' malpractice insurance premiums reflect the fact that any doctor can be sued at any time. Do you see now why US medical costs are highest in the world?

I didn't think about this angle, myself. But I have heard of it several times; my psychologist had some problems with being sued himself, and it did some real harm to his practice.

Either way, it does seem to be causing more harm than good to both doctors and patients alike.

 

[luchog]

But hang on. You claim to have the best health care system in the world.

No, he didn't.

Why on earth would so many physicians in the US be being sued if they all provide such a good service?

He just said why, weren't you paying attention?

In the US tort system, even if the doctor wins, he loses, because the cost of winning is often higher than the cost of simply settling the suit. This applies to many different industries besides medicine.

Because of this situation people sue for every little thing, and it's very easy and cheap to file such a lawsuit. So greed ensures that many people will file spurious lawsuits, knowing that the doctors will simply settle out of court, rather than ensuring the expensive and hassle of a trial. Even large corporations will typically settle rather than endure the cost of a suit. It's free money if you can work it right.

 

[Ivor the Engineer]

No, he didn't.

Quite correct.

He just said why, weren't you paying attention?

In the US tort system, even if the doctor wins, he loses, because the cost of winning is often higher than the cost of simply settling the suit. This applies to many different industries besides medicine.

Because of this situation people sue for every little thing, and it's very easy and cheap to file such a lawsuit. So greed ensures that many people will file spurious lawsuits, knowing that the doctors will simply settle out of court, rather than ensuring the expensive and hassle of a trial. Even large corporations will typically settle rather than endure the cost of a suit. It's free money if you can work it right.

Right, so Americans are greedy and will screw each other over to make an extra dollar. Do you think this attitude may extend to those in the medical profession, or are physicians different to the typical American?

How could you, as a patient, tell if your physician was selling you more health care than you would choose given more knowledge? Or perhaps even worse from a patient's point of view, was not referring you on to another more appropriate physician to avoid loosing the fee for treating you?

 

[Darat]

Still waiting for arguments as to why a private system is innately superior to a public funded system.

As for those in the USA who seem to be very skeptical that their government could do as good a job as other governments do throughout the world in ensuring very good health coverage for everyone, that is just an argument that your government needs improvement not an argument for private health care. (Given how successful many other governments are at ensuring all their populations receive excellent health care.)